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Oxygen saturation index: an adjunct for oxygenation index in congenital diaphragmatic hernia

Journal of Perinatology volume 44, pages 354–359 (2024)Cite this article

Subjects

Abstract

Objective

Our objective was to investigate the correlation of Oxygen Saturation Index (OSI) with Oxygenation Index (OI) and determine OSImax values that could predict need for ECMO and death in Congenital Diaphragmatic Hernia (CDH).

Study design

This is a retrospective cohort study of infants with CDH admitted to a tertiary level VI NICU. Pearson’s correlation coefficient and simple linear regression analysis were used to investigate the OSI: OI correlation, and logistic regression analysis to investigate OSImax values that predicted need for ECMO and death.

Results

Among the 180 infants, OSImax value of >13 at 6 h of life (HOL) best predicted need for ECMO and death. There was a strong correlation between OSI: OI paired values (r = 0.876, p < 0.001). The linear regression equation was OI = −2.4 + 2.4(OSI).

Conclusion

OSI could be used as a valuable adjunct to OI in the clinical management of newborn infants with CDH.

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Fig. 1: Patient inclusion process diagram: Diagram depicting inclusion process for study.
Fig. 2: Reciever Operating Curve (ROC) analysis: ROC curve at 6 hour of life (HOL) for predicting need for ECMO and death.
Fig. 3: Scatter Plot: Scatter plot depicting correlation between OSI and OI paired values.
Fig. 4: Scatter Plot.

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Data availability

All data analyzed for this study have been included in the article. Additional inquiries regarding the data can be directed to the corresponding author.

References

  1. Tovar JA. Congenital diaphragmatic hernia. Orphanet J Rare Dis. 2012;7:1–5.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Gupta VS, Harting MT Congenital diaphragmatic hernia-associated pulmonary hypertension. InSeminars in Perinatology (2020) Feb 1 (Vol. 44, No. 1, 151167). WB Saunders.

  3. Kinsella JP, Steinhorn RH, Mullen MP, Hopper RK, Keller RL, Ivy DD, et al. The left ventricle in congenital diaphragmatic hernia: implications for the management of pulmonary hypertension. J Pediatr. 2018;197:17–22.

    Article  PubMed  Google Scholar 

  4. Patel N, Massolo AC, Kipfmueller F Congenital diaphragmatic hernia-associated cardiac dysfunction. InSeminars in perinatology (2020) Feb 1 (Vol. 44, No. 1, 151168). WB Saunders.

  5. Akinkuotu AC, Cruz SM, Abbas PI, Lee TC, Welty SE, Olutoye OO, et al. Risk-stratification of severity for infants with CDH: prenatal versus postnatal predictors of outcome. J Pediatr Surg. 2016;51:44–8.

    Article  PubMed  Google Scholar 

  6. Bruns AS, Lau PE, Dhillon GS, Hagan J, Kailin JA, Mallory GB, et al. Predictive value of oxygenation index for outcomes in left-sided congenital diaphragmatic hernia. J Pediatr Surg. 2018;53:1675–80.

    Article  PubMed  Google Scholar 

  7. Tan YW, Ali K, Andradi G, Sasidharan L, Greenough A, Davenport M. Prognostic value of the oxygenation index to predict survival and timing of surgery in infants with congenital diaphragmatic hernia. J Pediatr Surg. 2019;54:1567–72.

    Article  PubMed  Google Scholar 

  8. Tan YW, Adamson L, Forster C, Davies B, Sharkey D. Using serial oxygenation index as an objective predictor of survival for antenatally diagnosed congenital diaphragmatic hernia. J Pediatr Surg. 2012;47:1984–9.

    Article  PubMed  Google Scholar 

  9. Mileder LP, Buchmayer J, Baik-Schneditz N, Schwaberger B, Höller N, Andersen CC, et al. Non-invasively measured venous oxygen saturation as early marker of impaired oxygen delivery in preterm neonates. Front Pediatr. 2022;10:834045. Jan 28

    Article  PubMed  PubMed Central  Google Scholar 

  10. Maneenil G, Premprat N, Janjindamai W, Dissaneevate S, Phatigomet M, Thatrimontrichai A. Correlation and prediction of oxygen index from oxygen saturation index in neonates with acute respiratory failure. Am J Perinatol. 2021. https://doi.org/10.1055/a-1673-5251.

  11. Khalesi N, Choobdar FA, Khorasani M, Sarvi F, Haghighi Aski B, Khodadost M. Accuracy of oxygen saturation index in determining the severity of respiratory failure among preterm infants with respiratory distress syndrome. J Matern-Fetal Neonatal Med. 2021;34:2334–9.

    Article  PubMed  Google Scholar 

  12. Muniraman HK, Song AY, Ramanathan R, Fletcher KL, Kibe R, Ding L, et al. Evaluation of oxygen saturation index compared with oxygenation index in neonates with hypoxemic respiratory failure. JAMA Netw open. 2019;2:e191179.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Rawat M, Chandrasekharan PK, Williams A, Gugino S, Koenigsknecht C, Swartz D, et al. Oxygen saturation index and severity of hypoxic respiratory failure. Neonatology. 2015;107:161–6.

    Article  CAS  PubMed  Google Scholar 

  14. DesPrez K, McNeil JB, Wang C, Bastarache JA, Shaver CM, Ware LB. Oxygenation saturation index predicts clinical outcomes in ARDS. Chest. 2017;152:1151–8.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Ruano R, Lazar DA, Cass DL, Zamora IJ, Lee TC, Cassady CI, et al. Fetal lung volume and quantification of liver herniation by magnetic resonance imaging in isolated congenital diaphragmatic hernia. Ultrasound Obstet Gynecol. 2014;43:662–9.

    Article  CAS  PubMed  Google Scholar 

  16. Cohen J. A power primer. Psychol Bull. 1992;112:155–9.

    Article  CAS  PubMed  Google Scholar 

  17. Horn-Oudshoorn EJ, Vermeulen MJ, Crossley KJ, Cochius-den Otter S, Schnater JM, Reiss IK, et al. Oxygen saturation index in neonates with a congenital diaphragmatic hernia: a retrospective cohort study. Neonatology. 2022;119:111–8.

    Article  CAS  PubMed  Google Scholar 

  18. Horn-Oudshoorn EJ, Vermeulen MJ, Knol R, Te Pas AB, Cochius-den Otter SC, Schnater JM, et al. The oxygen saturation index as early predictor of outcomes in congenital diaphragmatic hernia. Neonatology. 2023;120:63–70.

    Article  CAS  PubMed  Google Scholar 

  19. Bickler PE, Feiner JR, Severinghaus JW. Effects of skin pigmentation on pulse oximeter accuracy at low saturation. J Am Soc Anesthesiologists. 2005;102:715–9. Apr 1

    Google Scholar 

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Authors and Affiliations

  1. Division of Neonatal-Perinatal Medicine, Baylor College of Medicine/Texas Children’s Hospital, Houston, TX, USA

    Srirupa Hari Gopal, Kelly F. Martinek, Amanda Holmes, Joseph L. Hagan & Caraciolo J. Fernandes

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  1. Srirupa Hari Gopal
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  2. Kelly F. Martinek
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  3. Amanda Holmes
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  4. Joseph L. Hagan
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  5. Caraciolo J. Fernandes
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Contributions

SHG: Conceptualization, Methodology, Investigation and Drafting and editing the initial manuscript. KM: Conceptualization, Investigation and Review of manuscript. AM: Conceptualization and review of manuscript. JLH: Methodology, Formal analysis and review of manuscript. CJF: Supervision, Conceptualization, methodology, formal analysis and review of manuscript.

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Correspondence to Srirupa Hari Gopal.

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Hari Gopal, S., Martinek, K.F., Holmes, A. et al. Oxygen saturation index: an adjunct for oxygenation index in congenital diaphragmatic hernia. J Perinatol 44, 354–359 (2024). https://doi.org/10.1038/s41372-023-01845-8

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